Network Relations Manager

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🔥 1 minute ago

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Logo of CVS Health

CVS Health

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

Healthcare Insurance • Retail • Wellness

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Designs, develops, contracts, maintains and enhances relationships with facilities, physicians and ancillary providers. • Manages and maintains relationships with healthcare providers within a network by negotiating contracts, evaluating provider performance. • Analyzes network provider performance and quality indicators, conducting regular assessments and audits. • Addresses and resolves escalated issues and concerns raised by network providers. • Collaborates with network contracting teams to negotiate and establish contractual terms and conditions.

🎯 Requirements

• Minimum of 5 years’ experience in provider relations, network management, healthcare contracting, or payer operations. • At least 3 years of experience within a Managed Care environment, supporting providers with contracting and contract management. • Strong working knowledge of healthcare business segments, products, and industry terminology. • Demonstrated problem-solving and decision-making skills. • Proven ability to collaborate cross-functionally to support provider network management initiatives. • Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint, Outlook). • Must reside in the state of Florida.

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • other resources, based on eligibility

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